帕金森病中的 Tau 蛋白正电子发射断层扫描成像：系统评价与荟萃分析。
Tau-PET imaging in Parkinson's disease: a systematic review and meta-analysis.
作者信息
Zhang Junjiao, Jin Jianing, Su Dongning, Feng Tao, Zhao Huiqing
机构信息
Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
出版信息
Front Neurol. 2023 Apr 27;14:1145939. doi: 10.3389/fneur.2023.1145939. eCollection 2023.
BACKGROUND
Pathological tau accumulates in the cerebral cortex of Parkinson's disease (PD), resulting in cognitive deterioration. Positron emission tomography (PET) can be used for imaging of tau protein. Therefore, we conducted a systematic review and meta-analysis of tau protein burden in PD cognitive impairment (PDCI), PD dementia (PDD), and other neurodegenerative diseases and explored the potential of the tau PET tracer as a biomarker for the diagnosis of PDCI.
METHODS
PubMed, Embase, the Cochrane Library, and Web of Science databases were systematically searched for studies published till 1 June 2022 that used PET imaging to detect tau burden in the brains of PD patients. Standardized mean differences (SMDs) of tau tracer uptake were calculated using random effects models. Subgroup analysis based on the type of tau tracers, meta-regression, and sensitivity analysis was conducted.
RESULTS
A total of 15 eligible studies were included in the meta-analysis. PDCI patients ( = 109) had a significantly higher tau tracer uptake in the inferior temporal lobe than healthy controls (HCs) ( = 237) and had a higher tau tracer uptake in the entorhinal region than PD with normal cognition (PDNC) patients ( = 61). Compared with progressive supranuclear palsy (PSP) patients ( = 215), PD patients ( = 178) had decreased tau tracer uptake in the midbrain, subthalamic nucleus, globus pallidus, cerebellar deep white matter, thalamus, striatum, substantia nigra, dentate nucleus, red nucleus, putamen, and frontal lobe. Tau tracer uptake values of PD patients ( = 178) were lower than those of patients with Alzheimer's disease (AD) ( = 122) in the frontal lobe and occipital lobe and lower than those in patients with dementia with Lewy bodies (DLB) ( = 55) in the occipital lobe and infratemporal lobe.
CONCLUSION
imaging studies with PET could reveal region-specific binding patterns of the tau tracer in PD patients and help in the differential diagnosis of PD from other neurodegenerative diseases.
SYSTEMATIC REVIEW REGISTRATION
背景
病理性tau蛋白在帕金森病（PD）患者的大脑皮质中蓄积，导致认知功能恶化。正电子发射断层扫描（PET）可用于tau蛋白成像。因此，我们对PD认知障碍（PDCI）、PD痴呆（PDD）及其他神经退行性疾病中的tau蛋白负荷进行了系统综述和荟萃分析，并探讨了tau PET示踪剂作为PDCI诊断生物标志物的潜力。
方法
系统检索了PubMed、Embase、Cochrane图书馆和Web of Science数据库中截至2022年6月1日发表的使用PET成像检测PD患者大脑中tau负荷的研究。采用随机效应模型计算tau示踪剂摄取的标准化平均差（SMD）。进行了基于tau示踪剂类型的亚组分析、荟萃回归分析和敏感性分析。
结果
荟萃分析共纳入15项符合条件的研究。PDCI患者（n = 109）颞下回的tau示踪剂摄取显著高于健康对照（HCs）（n = 237），内嗅区的tau示踪剂摄取高于认知正常的PD（PDNC）患者（n = 61）。与进行性核上性麻痹（PSP）患者（n = 215）相比，PD患者（n = 178）中脑、丘脑底核、苍白球、小脑深部白质、丘脑、纹状体、黑质、齿状核、红核、壳核和额叶的tau示踪剂摄取降低。PD患者（n = 178）额叶和枕叶的tau示踪剂摄取值低于阿尔茨海默病（AD）患者（n = 122），枕叶和颞下叶的tau示踪剂摄取值低于路易体痴呆（DLB）患者（n = 55）。
结论
PET成像研究可揭示PD患者tau示踪剂的区域特异性结合模式，有助于PD与其他神经退行性疾病的鉴别诊断。
系统综述注册
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